Deprescribing & its associated factors among middle & old-aged ambulatory patients with chronic disease (s): A hospital-based cross-sectional study.

Abstract

Background & objectives Malaysia is increasingly impacted by non-communicable diseases (NCDs), which overburden the healthcare system. The increasing number of NCDs has resulted in multimorbidity, which has led to polypharmacy. Inappropriate polypharmacy commonly has negative impacts. Therefore, this study investigated the prevalence of willingness-to-deprescribing and its associated factors among middle and old-age ambulatory patients with chronic disease(s). Methods A cross-sectional study was conducted from March-June 2024, using interviewer-assisted questionnaire administration, involving adults aged ≥40 yr who visited the outpatient pharmacy in a Malaysian tertiary care hospital. Results 83.2 per cent of the study participants were willing to deprescribe their medications if their doctor said it was possible. Factors such as patients' involvement in treatment [odds ratio (OR): 1.16; 95%confidence interval (CI): 1.02-1.32; P=0.02], appropriateness of deprescribing (OR: 1.17; 95% CI: 1.05-1.31; P=0.004), concerns about stopping medication (OR: 0.75; 95% CI: 0.67-0.83; P<0.001), and trust in physicians (OR: 1.26; 95% CI: 1.04-1.52; P=0.017) were found to be associated with the willingness towards deprescribing. Interpretation & conclusions The high prevalence (83.2%) of willingness to deprescribe among middle and old-age ambulatory patients demonstrates a promising opportunity for medication optimisation in Malaysian healthcare settings. The factors predicting their willingness to deprescribe were patients' involvement in treatment, perceived appropriateness of deprescribing, medication cessation concern, and physician-patient trust relationships.